Pathology Of Female Reproductive System
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A 33-year-old Caucasian female presents with a history of lower abdominal pain, fever, and purulent vaginal discharge. Pelvic examination reveals bilateral ovarian tenderness. Microscopic examination of the smears stained with Gram detects N. gonorrhoeae. Which of the following complications will most likely develop in this woman, if the disease is left untreated?
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Edometriosis
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Epithelial ovarian cancer
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Luteoma of pregnancy
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Ectopic pregnancy
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Amyloidosis
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Disorders of the female reproductive system can occur as a result of disease in one of the many varied reproductive organs. In our study of the pathology of the female reproductive system we have been able to cover the disorders and how to diagnose them. Take the quiz and find out more.
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- 2.
A 35-year-old female is evaluated for recurrent pregnancy loss. Pelvic MRI is shown. What is the cause of patient’s problem?
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Failure of Müllerian ducts to fuse
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Failure of Wolffian ducts to fuse
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Failure of Mullerian ducts to fuse with genitourinary sinus
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Failure of Wolffian ducts to fuse with genitourinary sinus
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Failure of Wolffian ducts to fuse with urogenital ridge
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Failure of Mullerian ducts to fuse with urogenital ridge
Correct Answer
A. Failure of Müllerian ducts to fuseExplanation
The correct answer is Failure of Müllerian ducts to fuse. This is because the image shows a pelvic MRI, which is used to evaluate the reproductive organs. The Müllerian ducts are responsible for the development of the female reproductive organs, including the uterus, fallopian tubes, and upper part of the vagina. If the Müllerian ducts fail to fuse properly, it can lead to abnormalities in these structures and can result in recurrent pregnancy loss.Rate this question:
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- 3.
The shown image from a Fallopian tube surgical specimen represents
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Salpingitis
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Hydrosalpinx
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Ectopic pregnancy
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Adenocarcinoma
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Clear cell carcinoma
Correct Answer
A. SalpingitisExplanation
The image shows inflammation and infection in the Fallopian tube, which is characteristic of salpingitis. Salpingitis is the inflammation of the Fallopian tubes usually caused by a bacterial infection. Symptoms include pelvic pain, fever, and abnormal vaginal discharge. The image shows the typical histological features of salpingitis, such as infiltration of inflammatory cells and destruction of the tubal epithelium. Hydrosalpinx refers to the accumulation of fluid in the Fallopian tube, while ectopic pregnancy refers to the implantation of a fertilized egg outside of the uterus. Adenocarcinoma and clear cell carcinoma are types of cancer and are not indicated by the image.Rate this question:
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- 4.
Few giant cells (shown) are found in Pap smear from an asymptomatic woman. Dx?
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Cervical intraepithelial neoplasia
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Carcinoma in situ
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Carcinoma
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HPV infection
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HSV infection
Correct Answer
A. HSV infectionExplanation
The presence of giant cells in a Pap smear from an asymptomatic woman suggests an HSV (Herpes Simplex Virus) infection. Giant cells are a characteristic feature of HSV infection and are not typically seen in other conditions such as cervical intraepithelial neoplasia or carcinoma. HPV (Human Papillomavirus) infection can cause changes in the cervical cells, but it does not typically present with giant cells. Therefore, the most likely diagnosis based on the given information is HSV infection.Rate this question:
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- 5.
A correct statement about vulvar leukoplakia
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Progresses to cancer in 100% of cases
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Never progresses to cancer
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Is associated with underlying malignancy
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A white asymptomatic plaque
Correct Answer
A. A white asymptomatic plaqueExplanation
Vulvar leukoplakia is a condition characterized by the presence of a white asymptomatic plaque on the vulva. It does not always progress to cancer, as suggested by the first option. While it is associated with underlying malignancy, it does not mean that every case will develop into cancer, as mentioned in the third option. Therefore, the correct statement about vulvar leukoplakia is that it presents as a white asymptomatic plaque.Rate this question:
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- 6.
An elder woman presents with the shown vulvar disorder. How would you designate the findings before biopsy had been done?
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Leukoplakia
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Lichen sclerosus
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Lichen simplex chronicus
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Psoriasis
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Condyloma accuminatum
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Vulvar intraepithelial neoplasia
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Squamous cell carcinoma
Correct Answer
A. LeukoplakiaExplanation
Leukoplakia is the correct answer because it refers to a condition characterized by thickened, white patches on the mucous membranes, including the vulva. It is often associated with chronic irritation or inflammation and can potentially progress to cancer. Without a biopsy, it is not possible to definitively diagnose the condition, but based on the given information and appearance of the vulvar disorder, leukoplakia is the most appropriate designation.Rate this question:
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- 7.
Biopsy is taken and shown. Dx?
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Condyloma accuminatum
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Vulvar intraepithelial neoplasia
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Squamous cell carcinoma
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Lichen simplex chronicus
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Lichen sclerosus
Correct Answer
A. Lichen sclerosusExplanation
Lichen sclerosus is a chronic inflammatory skin condition that primarily affects the genital area. It is characterized by white, shiny, and atrophic skin with itching and discomfort. Biopsy is often taken to confirm the diagnosis, and the histopathological findings typically show thinning of the epidermis, loss of rete ridges, and a band-like lymphocytic infiltrate. The other options listed in the question, such as condyloma accuminatum, vulvar intraepithelial neoplasia, squamous cell carcinoma, and lichen simplex chronicus, are less likely based on the given information.Rate this question:
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- 8.
Macro- and micro- presentation of the multiple lesions of the vulva is shown. Dx?
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Leukoplakia
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Condyloma accuminatum
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Verrucous carcinoma
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Squamous cell carcinoma
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Condylomata lata
Correct Answer
A. Condyloma accuminatumExplanation
The correct answer is Condyloma accuminatum. Condyloma accuminatum is a sexually transmitted infection caused by the human papillomavirus (HPV). It is characterized by multiple lesions on the vulva that have a cauliflower-like appearance. These lesions are usually painless and can vary in size. Leukoplakia is a white patch on the vulva that can be caused by chronic irritation or infection. Verrucous carcinoma and squamous cell carcinoma are types of vulvar cancer that present as single lesions rather than multiple lesions. Condylomata lata are a manifestation of secondary syphilis and typically appear as flat, painless, and moist lesions.Rate this question:
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- 9.
Carcinoma in situ is characterized by
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Minimal stromal invasion
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Minimal lymph node metastases
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Minimal cellular atypia regardless presence/absence of stromal invasion or metastases
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Solely intraepithelial accumulation of obviously malignant cells
Correct Answer
A. Solely intraepithelial accumulation of obviously malignant cellsExplanation
Carcinoma in situ is a non-invasive form of cancer where the cancer cells are confined to the original site and have not spread to surrounding tissues or organs. It is characterized by the presence of obviously malignant cells that are limited to the epithelial layer of the tissue. There is no invasion into the stroma or lymph node metastases. Additionally, regardless of the presence or absence of stromal invasion or metastases, there is minimal cellular atypia, meaning that the cancer cells still closely resemble normal cells. Therefore, the defining characteristic of carcinoma in situ is the solely intraepithelial accumulation of obviously malignant cells.Rate this question:
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- 10.
The shown image from a vulvar biopsy represents
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Papilloma
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Intraepithelial neoplasia
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Keratinizing squamous cell carcinoma
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Non-keratinizing squamous cell carcinoma
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Adenoma
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Adenocarcinoma
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Melanoma
Correct Answer
A. Keratinizing squamous cell carcinomaExplanation
The shown image from a vulvar biopsy represents keratinizing squamous cell carcinoma. This can be identified by the presence of keratinization, which is the process of hardening and forming a protective layer of keratin on the surface of the skin. Squamous cell carcinoma is a type of skin cancer that arises from the squamous cells in the outermost layer of the skin. The keratinization in the image indicates that the cancer cells have undergone this process, confirming the diagnosis of keratinizing squamous cell carcinoma.Rate this question:
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- 11.
A 40-year-old Caucasian female presents to the gynecologist for a routine checkup. Physical examination is unremarkable, but the Cytology report indicates presence of atypical squamous epithelial cells suspicious of high grade lesion (ASC-H). A biopsy is taken and the microscopic appearance of the specimen is shown for you evaluation. Which of the following is the most likely diagnosis?
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CIN 1
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CIN 2
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CIN 3
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Chronic cervicitis
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Carcinoma in situ
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Invasive squamous cell carcinoma
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Normal smear
Correct Answer
A. CIN 2Explanation
The most likely diagnosis based on the given information is CIN 2, which stands for cervical intraepithelial neoplasia grade 2. CIN 2 represents a moderate to marked dysplasia of the cervical epithelium, indicating a precancerous lesion. This diagnosis is supported by the presence of atypical squamous epithelial cells suspicious of high grade lesion on the cytology report. A biopsy would be necessary to confirm the diagnosis and determine the extent of the abnormality.Rate this question:
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- 12.
A 41-year-old woman visits her family physician for a routine check-up.Her physical and, particularly, gynecologic examination is unremarkable, and Pap smear is taken.Cytologic examination reveals numerous small-to-medium-sized epithelial cells with markedly enlarged nuclei with accentuated nuclear outline, clumped chromatin and visible nucleoli.Which of the following procedures is the most reasonable in management of this patient?
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Repeat Pap smear in 6 month
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Colposcopy
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Colposcopy and cervical biopsy
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Ablation
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Conization
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Hysterectomy
Correct Answer
A. Colposcopy and cervical biopsyExplanation
The most reasonable procedure in the management of this patient is colposcopy and cervical biopsy. The cytologic examination findings suggest the presence of abnormal cells in the cervix. Colposcopy allows for a more detailed examination of the cervix using a magnifying instrument, which can help identify any abnormal areas. Cervical biopsy is then performed to obtain a tissue sample for further evaluation and to confirm the presence of any precancerous or cancerous changes. This combination of procedures is necessary to assess the extent of the abnormality and guide further management decisions.Rate this question:
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- 13.
A 23-year-old Caucasian woman visited her gynecologist for a regular checkup. Cervical Pap smear was taken (see the image below) and the cytologist recommended repeating cervical cytology in six months. What was the most like reason for such suggestion?
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The lesion can progress to low-grade SIL
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The lesion can progress to high-grade SIL
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The lesion can directly progress to invasive carcinoma
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The patient has a sexually transmitted disease
Correct Answer
A. The lesion can progress to high-grade SILExplanation
The most likely reason for the suggestion to repeat cervical cytology in six months is that the lesion seen in the Pap smear has the potential to progress to high-grade squamous intraepithelial lesion (SIL). High-grade SIL is a precancerous condition that has a higher risk of progressing to invasive carcinoma if left untreated. Therefore, close monitoring and follow-up are necessary to detect any progression and initiate appropriate management if needed.Rate this question:
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- 14.
A 33-year-old woman presents with vaginal bleeding. At colposcopy, a vaginal mass is found and biopsied; subsequent histologic examination reveals atypical glands lined by large cells with clear cytoplasm, many of the cells have hobnail appearance. Which of the following etiologic factors was most likely implicated in development of the shown pathology?
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HPV exposure
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Intrauterine folic acid deficiency
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Intrauterine x-ray exposure
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Peroral DES administration
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Intrauterine DES exposure
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Hormone-producing ovarian tumors
Correct Answer
A. Intrauterine DES exposureExplanation
The histologic examination findings of atypical glands lined by large cells with clear cytoplasm and hobnail appearance are consistent with the pathology seen in patients with intrauterine DES exposure. DES (diethylstilbestrol) is a synthetic estrogen that was used in the past to prevent miscarriages. However, it was later found to be associated with various adverse effects, including an increased risk of vaginal adenocarcinoma in female offspring exposed to DES in utero. Therefore, intrauterine DES exposure is the most likely etiologic factor implicated in the development of the vaginal mass in this patient.Rate this question:
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- 15.
A 29-year-old promiscuous woman present to the gynecologist for a routine checkup. Physical examination is unremarkable, but the Pap smear report indicates the presence of atypical squamous epithelial cells of undermined significance (ASC-US). The smear is repeated in six months, but cytologic abnormalities persist. Subsequent cervical biopsy reveals epithelial changes shown for you evaluation. Which of the following is the most likely diagnosis?
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Normal cervix with non-keratinizing squamous epithelium
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Chronic cervicitis with repair
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Mild dysplasia
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Moderate dysplasia
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Severe dysplasia
Correct Answer
A. Normal cervix with non-keratinizing squamous epitheliumExplanation
The correct answer is "Normal cervix with non-keratinizing squamous epithelium." This is the most likely diagnosis because the patient's physical examination is unremarkable and the Pap smear report indicates atypical squamous epithelial cells of undermined significance (ASC-US). The repeat smear in six months still shows cytologic abnormalities, but subsequent cervical biopsy reveals a normal cervix with non-keratinizing squamous epithelium. This indicates that there are no significant epithelial changes or dysplasia present.Rate this question:
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- 16.
A 74-year-old woman presents with a pruritic lesion on the external genitalia. The gross and microscopic appearance of the lesion is shown for your evaluation. Which of the following is the most likely diagnosis?
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Verrucous carcinoma
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Lichen simplex chronicus
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Lichen sclerosus
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Squamous cell carcinoma
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Extramammary Paget disease
Correct Answer
A. Extramammary Paget diseaseExplanation
Extramammary Paget disease is the most likely diagnosis based on the clinical presentation of a pruritic lesion on the external genitalia. The gross and microscopic appearance of the lesion supports this diagnosis. Verrucous carcinoma is a type of squamous cell carcinoma characterized by a warty growth pattern, which is not seen in this case. Lichen simplex chronicus is a localized area of chronic itching and scratching, but it does not typically present as a distinct lesion. Lichen sclerosus is a chronic inflammatory condition that primarily affects the vulva, but it does not typically present as a pruritic lesion. Squamous cell carcinoma is a possibility, but Extramammary Paget disease is more likely given the specific clinical and histological findings.Rate this question:
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- 17.
A 26-year-old Hispanic female presents with oligomenorrhea and infertility. An endometrial biopsy is obtained at the twenty first day of menstrual cycle. Histologic examination reveals small, slightly irregular glands and a few mitotic figures in the glands and stroma. Which of the following is the most likely cause of oligomenorrhea and infertility in this woman?
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Anovulatory cycle
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Endometrial hyperplasia
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Endometrial polyp
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Chronic endometritis
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Endometrial carcinoma
Correct Answer
A. Anovulatory cycleExplanation
The most likely cause of oligomenorrhea and infertility in this woman is anovulatory cycle. Anovulatory cycle refers to a menstrual cycle in which ovulation does not occur. This can lead to hormonal imbalances and irregularities in the menstrual cycle, resulting in oligomenorrhea (infrequent or irregular menstrual periods) and infertility. The histologic findings of small, slightly irregular glands and a few mitotic figures in the glands and stroma support the diagnosis of anovulatory cycle. Endometrial hyperplasia, endometrial polyp, chronic endometritis, and endometrial carcinoma are less likely causes in this scenario.Rate this question:
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- 18.
A 48-year-old Caucasian female presents with vaginal bleeding. Endometrial biopsy reveals simple endometrial hyperplasia. Which of the following histologic changes in the endometrium allowed the pathologist to establish this diagnosis?
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Atrophic endometrium with cystically dilated glands
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Proliferative phase endometrium with few cystically dilated glands
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Crowded glands with outpounching and cytologic atypia
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Subnuclear vacuolation of the glandular epithelium
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Spiral arteries surrounded by decidual cells
Correct Answer
A. Proliferative phase endometrium with few cystically dilated glandsExplanation
The correct answer is "Proliferative phase endometrium with few cystically dilated glands." In simple endometrial hyperplasia, there is an increase in the number of glands in the endometrium, but they are not crowded or showing cytologic atypia. The presence of few cystically dilated glands indicates that the endometrium is in the proliferative phase, which is consistent with the diagnosis of simple endometrial hyperplasia. Atrophic endometrium with cystically dilated glands is more commonly seen in postmenopausal women. Crowded glands with outpouching and cytologic atypia are characteristic of complex endometrial hyperplasia with atypia. Subnuclear vacuolation of the glandular epithelium is seen in Arias-Stella reaction, which is associated with pregnancy or gestational trophoblastic disease. Spiral arteries surrounded by decidual cells are seen in the secretory phase of the menstrual cycle.Rate this question:
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.JPG "A 35-year-old female is evaluated for recurrent pregnancy loss. Pelvic MRI is shown. What is the cause of patient’s problem?")
.JPG "The shown image from a Fallopian tube surgical specimen represents")
.JPG "Few giant cells (shown) are found in Pap smear from an asymptomatic woman. Dx?")
.JPG "An elder woman presents with the shown vulvar disorder. How would you designate the findings before biopsy had been done?")
.JPG "Biopsy is taken and shown. Dx?")
.JPG "Macro- and micro- presentation of the multiple lesions of the vulva is shown. Dx?")
.JPG "The shown image from a vulvar biopsy represents")
.JPG "A 40-year-old Caucasian female presents to the gynecologist for a routine checkup. Physical examination is unremarkable, but the Cytology report indicates presence of atypical squamous epithelial cells suspicious of high grade lesion (ASC-H). A biopsy is taken and the microscopic appearance of the specimen is shown for you evaluation. Which of the following is the most likely diagnosis?")
.JPG "A 23-year-old Caucasian woman visited her gynecologist for a regular checkup. Cervical Pap smear was taken (see the image below) and the cytologist recommended repeating cervical cytology in six months. What was the most like reason for such suggestion?")
.JPG "A 29-year-old promiscuous woman present to the gynecologist for a routine checkup. Physical examination is unremarkable, but the Pap smear report indicates the presence of atypical squamous epithelial cells of undermined significance (ASC-US). The smear is repeated in six months, but cytologic abnormalities persist. Subsequent cervical biopsy reveals epithelial changes shown for you evaluation. Which of the following is the most likely diagnosis?")
.JPG "A 74-year-old woman presents with a pruritic lesion on the external genitalia. The gross and microscopic appearance of the lesion is shown for your evaluation. Which of the following is the most likely diagnosis?")
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Mar 22, 2023Quiz Edited by
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Nov 06, 2016Quiz Created by
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